Neurofibroma subungueal solitário: relato de um caso inédito no sexo masculino

Abstract

A neurofibroma is a hamartomatous proliferation of neuromesenchymal origin. It may be found in combination with neurofibromatosis or in the form of a solitary tumor. Clinical presentation as a solitary subungual tumor is very rare. Neurofibroma is more common in females and surgery is the treatment of choice. The present paper reports the case of a male patient with a subungual tumor on his toe. Biopsy and immunohistochemistry findings were compatible with a neurofibroma. To date, fewer than ten cases of subungual neurofibromas unassociated with von Recklinghausen's disease have been documented, this being the first case to be reported in Brazil and the only report worldwide to have described this condition in a male patient.

Nail bed solitary neurofibroma

“…They tend to be small tumors (range 0.5 cm to 1.8 cm) with nonspecific clinical features. [3,8] These tumors are slow growing and rarely painful. No complaint of pain was recorded in all cases but 1, our case included.…”

“…There was 1 case with no nail plate deformity. [8] Due to these features nail bed solitary neurofibroma is difficult to diagnosis. Other tumors such as glomus tumor, Koenen tumor, fibrokeratoma, or squamous cell carcinoma may clinically mimic neurofibroma and must be included in the differential diagnosis.…”

“…[14] In 1 case ultrasound exam showed a hypoechoic mass without Doppler flow, while in our case a hyperechoic mass with low-intensity Doppler flow was found. [8] Magnetic resonance imaging (MRI) appearance of neurofibromas is nonspecific, similar to that of schwannomas. They generally exhibit hypo- to isointense signal to muscle on T1-weighted images and hyperintense signal on T2-weighted sequences, with a variable enhancement pattern and foci of heterogenity.…”

A unique case of hereditary bilateral segmental neurofibromatosis on the face

“…7-9 Common affected sites reported for SN are the thorax and abdomen in 55% of cases, upper extremities and inguinal⁄axillary in 20% each, lower limb and face in 10% each. 10 Cases of SN have been reported in association with extracutaneous manifestations including visceral neurofibromas, soft tissue hypertrophy, skeletal abnormality, and unilateral renal agenesis. Generally, there is no family history of similar disorder in patients with SN and it has been reported in only eight cases.…”